Teens on Depression Meds Don’t Always Get Appropriate Follow-Up

By staff

New York—Many teenagers filling prescriptions for depression medications might not be getting the follow-up care they need.

That’s according to an article published online by JAMA Pediatrics. New York University School of Medicine–led researchers found that while most adolescents with newly identified depression symptoms received some treatment within 3 months, some of them did not receive any follow-up care. In fact, according to the report, 40% of teens prescribed antidepressant medication did not have any documented follow-up care for 3 months.

Background information in the article notes that major depression affects 12% of adolescents, with as many as 26% of those in that age cohort experiencing at least mildly depressive symptoms. Beginning treatment in a timely manner is essential, the authors note, because failing to achieve remission of depression is associated with a higher likelihood of recurrent depression and more impaired long-term functioning.

For the study, the researchers analyzed routine care in three large healthcare systems, assessing whether adolescents with newly identified depression symptoms received appropriate care in the 3 months following identification of the symptoms. Appropriate follow-up care was defined as initiating antidepressant or psychotherapy treatment, having at least one follow-up visit, and symptom monitoring with a questionnaire.

Among 4,612 participants—mostly female and with an average age of 16—treatment was initiated for 2,934, with most receiving psychotherapy alone or in conjunction with medications, according to the results.

In the 3 months after symptoms were identified, however, 36% of adolescents received no treatment, 68% had no follow-up symptom assessment, and 19% received no follow-up care whatsoever, the study details.

Furthermore, 40% of adolescents prescribed antidepressant medication did not have follow-up care documented for 3 months. That can be especially problematic in light of another recent study finding that adolescents and children have a doubled risk of aggression and suicide when taking one of the five most commonly prescribed antidepressants. The Danish systematic review and meta-analysis of 70 trials with more than 18,000 patients was published recently in The BMJ .

Rates of follow-up care differed among the three sites in the study, which relied on medical record data from electronic health records.